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PL-16-3243Project Address 162 NE 106 Street Miami Shores, FL Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -11-16-3243 Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: APPROVED Issue Date: 3/31/2017 Expiration: 09/27/2017 Parcel Number 1121360050030 Block: Lot: Applicant BRANDON SIMON Owner Information Address Phone Cell BRANDON SIMON 162 NE 106 Street MIAMI SHORES FL 33138- 162 NE 106 Street MIAMI SHORES FL 33138- Contractor(s) ESSIG POOLS INC Phone 305-949-0000 Cell Phone Valuation: Total Sq Feet: $ 1,500.00 950 Type of Work: PLUMBING FOR NEW POOL Type of Piping: Additional Info: PLUMBING FOR NEW POOL Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $3.38 $3.38 $0.40 $225.00 $3.00 $1.60 $237.96 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -11-16-62206 03/31/2017 Check #: 301416 $ 187.96 $ 50.00 11/30/2016 Check #: 301071 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Main Drain Final Rough Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is • , rate a that F II work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named cork stated. Authorized Signature: Owner / Applicant / Cont Building Department Copy Agent March 31, 2017 Date March 31, 2017 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC *PLUMBING ❑ MECHANICAL JOB ADDRESS City: F&io/Parcel#: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 . Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑ ROOFING ❑PUBLIC WORKS 1 CD Le 1 NOV 302011I6 FBC 201q Master Permit No. nip - A 7 L 1 I Sub Permit No. 1-' i l 60, - 32(43 ❑ REVISION ❑ EXTENSION ❑RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Shores 112.I3CPCDos Cou ntv: Miami Dade zip: 33 13 a Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): I Address: 4•-• 2- 1 P Construction Type: L I 1 I\.. \/.... {a iu2 h'iiil1 iil5 iliwiui iCml1 y vc�lguaw 1 c� Flood Zone: ST n1r1 ✓ IYLI BFE: FFE: Phone#: `� I - (oCo Z - �"'"" �- r City: r �' ` ' '"�` 1 S lam► Q ° S State: Tenant/Lessee Name: Phone#: zip: 3313 -8 Email: CONTRACTOR: Company Name: ESSIG POOLS, INC Address: 1800 NE 151 ST Phone#: 305-949-0000 City: NORTH MIAMI State: FL Qualifier Name: DANIEL ESSIG State Certification or Registration #: CPC052505 DESIGNER: Architect/Engineer: SkN) Z o L.o L-r� Address: zip: 331625 Phone#: 305-949-0000 Certificate of Competency #: PF r 1 �•q Phone#: 2--"5S City: 64 -111 -C -1.f,) "-1. State: F- zip: 35 1 Value of Work for this Permit: $ Type of Work: ❑ Addition ❑ Alteration New Description of Work: P l 1/4_-' r-. ' k /11 .1.=1 11 S� Square/Linear Footage of Work: � • ❑ Repair/Replace ❑ Demolition • r ...,,. Specify color of color thru tile: Submittal Fee $ `' I� P b: Permit Fee $ Scanning Fee $ Radon Fee $ - 2).23 Technology Fee $ t ' ! C� Structural Reviews $ (Revised02/24/2014) Training/Education Fee $ CCF $ ' LO CO/CC $ DBPR $ 5 • S3 Notary $ •0© Double Fee $ Bond $ TOTAL FEE NOW DUE $ 175 ,01(0 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address 1 City 1 State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) da s after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a rein - ion f- will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this n day of 1"J',==.\ --t-.-1 20 t , by C , , who is personally known to me or who has produced FL— D P.%\fr r S =I Cna' identification and who did take an oath. NO Y PUBLIC: Signature CONTRA The foregoing instrument was .cknowledged before me this 2-1 day of IN.] 'r==='-\/ " , 20 t by DANIEL ESSIG , who is personally known to me or who has produced as identification and who did take an oath. NOTARY P Sign Print: Seal: YORLENY M. HERNANf)2 MY COMMISSION # FF 022}5(gn • E • I • ES: September 27, 2017 Bonded Thru Notary Public Underwtitritll Seal s LI ''EgN4NDEZ U*FF022108 k= -EXPIRES: September 27, 2017 Bonded Thra Notary Public Underwriters ************************************************************************* APPROVED BY .o/4/ - 27-0 Plans Examiner Structural Review (Revised02/24/2014) **(*** *********************** Zoning Clerk